Just Ask: Could it be Sepsis?
Just Ask: Could it be Sepsis?
February 19, 2019
Sepsis is a ‘silent killer’ that can happen as a response to any injury or infection, anywhere in the body. We spoke to Melissa Mead from the UK Sepsis Trust who explains how important it is for all healthcare professionals to be able to recognise the signs and symptoms of sepsis.
I’d like to introduce you to my one-year old son William. This photo was taken in October 2014, his first nursery photo. At the time William had just developed a cough, it sounded fairly self-limiting, systemically he was well, but he just couldn’t shake this chesty cough. We took William to the doctors where he was examined and found to be suffering with a viral cough, no treatment was needed, as we suspected.
Over the coming weeks we returned to the doctors with William several times as the cough persisted, nothing new, we were told. Just a virus. When William begun to vomit we sought a second opinion from another doctor; ‘it’s just viral, his chest is clear’. The end of November came and we celebrated William’s first birthday. Just a few short days later on Friday 12th December William started to run a temperature at nursery, despite administering paracetamol his temperature continued to rise. We collected him immediately and took him to the emergency doctor. We had to sit and wait until the end of the day, William was examined. Despite his temperature of 40.1c, the persistent cough and vomiting we were assured William was fine, his chest and ears were clear. He just had a viral infection and would get better without treatment.
Over the weekend we contacted more doctors and were told on each occasion the best place for William was at home with plenty of rest and fluids. “Goodnight sweetheart, I love you” were the words I whispered to William when I tucked him in to bed on Saturday 13th December. These were the last words my son would ever hear. On Sunday morning when I went in to check on him, I found that William had passed away. Despite a paramedic’s best efforts, William had already left us.
It was found after the inquest and an NHS England investigation that there were 16 failings in William’s care and 4 missed opportunities to save his life. He in fact had been suffering with a bacterial chest infection, pneumonia, and in the last days of his life he had a collapsed lung, a pleural effusion and ultimately developed sepsis which took his life.
The first time I heard the word sepsis was when we saw William’s death certificate. The doctors didn’t think sepsis, we weren’t informed about sepsis and there was no awareness around this deadly condition. This is why I joined the UK Sepsis Trust to campaign for better public awareness as well as raising the profile within the wider health care profession.
Are you Sepsis aware?
At the UK Sepsis Trust, we are passionate about raising awareness of this potentially life-threatening condition that affects 250,000 people every year in the UK. Sepsis (previously known as blood-poisoning) is the body’s reaction to an infection in which the body attacks its own tissues and organs, and it kills 44,000 people in the UK every year. It is more common than heart attacks and kills more people than bowel, breast and prostate cancer combined. The NHS acknowledges it as the ‘silent killer’. Sepsis, however, can be treated effectively with antibiotics if caught promptly.
Awareness can and does save lives, so it is imperative that those professionals who are caring for patients are able to spot the signs and symptoms of sepsis and act quickly. In particular, it is important to know what ‘worse’ looks like.
So what causes sepsis?
Normally your body’s immune system responds to infection by working to fight any germs (bacteria, viruses, fungi), or to prevent infection. However, for reasons we do not fully understand, sometimes the immune system goes in to overdrive. It can happen as a response to any injury or infection, anywhere in the body. It can result from:
- A chest infection like pneumonia
- A urinary tract infection (UTI)
- A problem in the abdomen like gastroenteritis, or problems like a burst ulcer or a hole in the bowel
- An infected cut or bite
- A wound from trauma or surgery
- A leg ulcer or cellulitis
- Dental infection
Sepsis can be caused by a huge variety of different germs, like streptococcus, e-coli, MRSA or C Diff. Most cases are caused by common bacteria, which normally don’t make us ill. It doesn’t discriminate and can strike at any time.
Sepsis is a major cause of death in the UK and 14,000 sepsis-related deaths are preventable. Patients with known infections are vulnerable, their sepsis symptoms are often misinterpreted as self-limiting conditions such as flu or gastroenteritis, potentially resulting in delayed treatment. It’s highly unpredictable, and the speed and severity vary from case to case. In some cases, it can develop over the course of several days, it others, it can simply be a matter of hours.
When treating the younger patient, language and understanding can be a barrier. Children can often compensate well during a disease process like sepsis. This means that subtle changes can be missed until they suddenly become extremely unwell. It is so important to trust your instincts.
Signs and Symptoms
As a healthcare provider, it is important that you, your staff and patients are aware of the signs and symptoms and are able to seek the appropriate medical care without delay, when infection is diagnosed. Early recognition, diagnosis and treatment dramatically improves outcomes from sepsis. These are the symptoms to be aware of:
Raising awareness of sepsis in your community, not just amongst staff but also patients, will no doubt save lives. At the UK Sepsis Trust our goal is to end preventable deaths from sepsis and improve outcomes for sepsis survivors.
With help from supporters we are putting sepsis on the national and global agenda. We encourage you to think about sepsis when you are caring for a patient that you suspect has or already has an infection; and if you are unsure always Just Ask: Could it be Sepsis?
NICE Clinical Knowledge Summary: Feverish Children Risk Assessment
The summary was updated in November 2018 and advises pharmacists to use a traffic light system and assess the whole child in the context of the history provided by the parent/carer.
Posted in: Services & Commissioning